Presenter: Hillary Craddock Status: Graduate Student

Abstract: Introduction: Shigella infection, also known as Shigellosis, is a common gastrointestinal illness in the United States; it has been estimated that the average U.S. incidence is 4.82 cases per 100,000 population. Previous studies have investigated the relationship between agricultural exposures or certain socioeconomic factors and Shigella incidence rates. However, these studies were often limited to one state or region and did not investigate the combined impact of agricultural and socioeconomic factors on Shigella incidence. Methods: Shigella case data (2004-2010; n= 10,789) were collected from the Foodborne Diseases Active Surveillance Network (FoodNet). Socioeconomic and agricultural data were obtained from the 2010 Census of Population and Housing, the 2011 American Community Surveys, and the 2007 Census of Agriculture. These data were then linked by zip code. Incidence rate ratios were derived using negative binomial regression models. Results: Multiple community-level socioeconomic and agricultural factors were associated with Shigella incidence rates. For example, in Minnesota the presence of aquaculture operations was strongly associated with Shigella incidence (IRR: 2.13; p-value: <0.01). In Georgia, the presence of swine operations was associated with Shigella incidence (IRR: 1.36; p-value: 0.02). Indicators of poverty, including the percentage of the population over age twenty-five without a high-school diploma (IRR: 1.02; p-value: <0.01) and the percentage of the population living below the poverty line (IRR: 1.02; p-value: 0) were also associated with higher incidence rates. The percentage of housing units in rural areas were also associated with Shigella incidence rates (IRR: 0.99; p-value: <0.01); this protective effect provides evidence that more crowded, urban areas are characterized by higher Shigella incidence rates. Conclusion: The socioeconomic and agricultural factors present in a community are important to consider when evaluating an individual’s risk for Shigellosis. Additionally, targeted interventions in high-risk communities may reduce the incidence and burden of this illness.

Effects of a 12-week exercise intervention on resting state brain networks in MCI and healthy elders

Presenter: Theresa Smith Status: Graduate Student

Abstract: Background: It is important to identify treatments to improve brain function in Mild Cognitive Impairment (MCI), an early stage of Alzheimer’s Disease (AD). Previous studies have shown a disruption in resting state brain networks on the AD continuum, and while physical activity appears to delay the onset of AD, it is unknown if it alters resting state brain networks in clinical populations. We investigated the effects of a 12-week treadmill walking intervention on resting state brain networks in MCI and healthy elders. Methods: Sixteen MCI and 16 healthy elders, ages 60-88, engaged in a supervised 12-week treadmill walking exercise intervention. Functional MRI (fMRI) was acquired at rest, and the voxel time courses were parceled into 90 brain regions using the AAL atlas. Correlation matrices (90x90) for each subject were entered into the NBS Connectome. Results: Using the FDR option [paired t-test; 10,000 permutations] significant connection changes (p<0.05) were found in the healthy elders but not in the MCI. Healthy elders decreased connectivity between the left thalamus and left superior orbital gyrus. Reducing permutations to 5,000 revealed decreased connectivity between the left superior orbital gyrus and the following nodes: left caudate nucleus, left pallidum, and right thalamus. Conclusions: These findings suggest 12-weeks of exercise alter functional connectivity patterns in the healthy elders, yet there is an apparent maintenance of network function in MCI. This indicates that walking may provide protective benefits to resting state networks in healthy elders while delaying the disruption of these networks in MCI. These findings continue to lend support to the use of exercise as a therapeutic intervention in MCI. It must be noted that the small number of subjects does limit the sensitivity of the analysis to detect differences.

Factor Structure of a Revised Spiritual Health Locus of Control (SHLOC) Scale in a National Sample of African Americans

Presenter: Daisy Le Status: Graduate Student

Abstract: Background: Spiritual health locus of control (SHLOC) beliefs reflect the extent to which a person feels that a higher power (e.g., God) plays a role in their health. The SHLOC scale includes both an “active” (e.g., God + [self; doctors] = health) and a “passive” (e.g., God > [self; doctors] = health) subscale. We revised the SHLOC scale, adding items to better reflect the passive dimension of SHLOCbeliefs. Methods: The revised SHLOC scale includes 27 statements, including new items tapping the passive dimension (e.g., “If I am close to God, I don’t need to see a doctor for healing”). N=497 African Americans completed the revised SHLOC as part of a national telephone health survey. The factor structure of the new scale was examined using principal components analysis. Results: A two-factor structure (active, passive) was found to fit the data with most items loading on the intended factor. Exceptions were three items with ambiguous or low factor loadings, which were eliminated, resulting in a 24-item revised scale. Internal reliability was strong for both the final active (α= .91) and passive (α= .92) dimensions. Discussion: The revised SHLOC scale does a better job of assessing both the active and passive dimensions of these complex beliefs about the combined roles of self, doctors, and God in health. Such beliefs have salience for African Americans in the way that many think about health and illness, and have implications for integration into culturally targeted health promotion interventions and faith-based initiatives in health care policy.

Familial Influences on Tobacco and Marijuana Use: Perspectives from Young People

Presenter: Elizabeth L Seaman Status: Graduate Student

Authors: Elizabeth L. Seaman, MHS and Craig S. Fryer, DrPH, MPH

Abstract: Available unitl 12:15pmBACKGROUND: Empirical research supports that a link exists between parental tobacco smoking behaviors and the risk for adolescent tobacco and marijuana use. Yet, few studies have included the viewpoints of young people to explore how this relationship differs for tobacco and marijuana. METHODS: We conducted a convergent parallel mixed methods pilot study with a convenience sample of young people in the Pittsburgh area. Fifty-eight participants between the ages of 13-20 completed a survey about experiences with smoking and other health issues. Subsequently 24 young smokers were invited to participate in five focus groups to discuss their experiences with marijuana and tobacco. RESULTS: The majority of the sample self-identified as African American/black (81%) and was male (56.9%). Half of survey participants reported being ever or current cigarette smokers while 62.1% of the sample reported being ever or current marijuana smokers. Almost half (44.8%) of current cigarette smokers reported cessation attempts at least once, with the majority reporting 1-3 attempts. Participants acknowledged the profound role family members smoking had on their smoking attitudes and behaviors. The majority of the survey respondents (62.1%) live with a smoker. In the focus groups, participants described initiation of smoking and family knowledge of their smoking status. Participants also described the ways in which family members’ smoking influenced access to tobacco products, conceptions of nicotine addiction and health risks, and concern for younger siblings. CONCLUSION: Mixed methods research designs allow for the examination of multifaceted phenomena such as the dual use of tobacco and marijuana.

From Pre-harvest to Puff: Bacterial Community Composition Differs Between Mentholated and Non-mentholated Cigarette Tobacco

Abstract: There is a paucity of data regarding the microbial constituents of tobacco products and their impacts on public health. Specifically, there has been no comparative characterization performed on the bacterial microbiota associated with the addition of menthol, an additive that has been used by tobacco manufactures for nearly a century. To address this knowledge gap, we conducted high-throughout 16S rRNA analysis on commercially mentholated, lab mentholated and non-mentholated cigarette products. Comparative analysis of alpha and beta diversity revealed a significant decrease in diversity among mentholated products and altered bacterial compositions among the mentholation states. This was particularly significant in the case of a product that was commercially mentholated. In addition, mentholation appeared to correlate with the reduction in potential pathogens and an increase in species resistant to harsher environmental conditions. Taking together, these data provide preliminary evidence that the mentholation process used in the production of commercially available cigarettes can impact the bacterial communities in these products, which may have a direct impact on the users health.

Presenter: Erin K. Tagai Status: Graduate Student

Abstract: African Americans are disproportionately impacted by colorectal cancer (CRC) incidence and mortality. Early detection of CRC can lead to reduced incidence and mortality. However, African Americans are screened for CRC at lower rates than Whites. The ability to make an informed decision regarding CRC screening is related to increased screening completion. Health literacy has been linked to increased CRC screening knowledge, however research investigating the link between health literacy and CRC screening decision making is limited. The study was conducted in the context of Project HEAL (Health through Early Awareness and Learning), a church-based intervention focusing on cancer early detection intervention. A total of 101 participants attended a series of 3 workshops and completed surveys at baseline and 12-months, and an additional follow-up survey at 14-months focusing on health literacy and decision making. Health literacy was a significant predictor of decisional conflict, decision self-efficacy, and state of decision-making for CRC screening. Individuals with greater health literacy had greater decision self-efficacyand health literacy was inversely related to decisional conflict (ps < .05). Lastly, individuals with increased health literacy were closer to making a CRC screening decision (p < .05). The findings suggest health literacy is associated with CRC screening decision making among this sample of church-attending African Americans. Future studies should further investigate the relationship between health literacy and decision making as well as the inclusion of health literacy in decision making tools for CRC screening.

Persons Receiving Buprenorphine for Outpatient Treatment of Opioid Disorders: Are They Different if They Also Used Heroin?

Presenter: Katherine Garcia-Rosales Status: Undergraduate Student

Authors: Katherine Garcia-Rosales and Eric D. Wish, Ph.D.

Abstract: With the growing prescription opioid (painkiller) epidemic in the United States (U.S.), there has been an escalation in the number of heroin users, suggesting a shift to heroin use by people who cannot obtain prescription opioids. This development raises the question of whether there is a new type of heroin user emerging from this prescription opioid epidemic. This descriptive quasi-experimental study compares and describes the characteristics of 157 patients who used prescription opioids and/or heroin. The participants are members of outpatient opioid treatment programs who are being prescribed buprenorphine and who completed a self-report questionnaire about their drug use history. The research compares the responses of patients who responded prescription opioids only and those who used a combination of prescription opioids and heroin. The analysis of this study suggests that prescription opioid users who had also used heroin appear to be very similar to the heroin users that have been described in prior literature. Patients who used heroin were more likely to have misused other drugs, to have begun use earlier, and to engage in polydrug use. The implications of the findings for treating prescription opioid abusers who have or have not used heroin and suggestions for future research are discussed.